Distributed Medical Sensing System and Method

ABSTRACT

A distributed medical sensing system including a first body sensing device configured to sense medical characteristics, the first body sensing device being located in a first sterile field and a second body sensing device configured to sense medical characteristics, the second body sensing device being located in a second sterile field, the second sterile field being spaced from the first sterile field. The syJostem also includes a computing device outside of the first and second sterile fields and communicatively coupled to the first and second body sensing devices, the computing device configured to respectively receive first and second medical characteristic data from the first and second body sensing devices, process the first and second medical characteristic data, and transmit the processed first and second medical characteristic data to respective first and second user interface devices.

TECHNICAL FIELD

Embodiments of the present disclosure relate generally to the field ofmedical devices and, more particularly, to sensing and imaging systemsand associated methods of use.

BACKGROUND

This application is a continuation of PCT Patent Application No. PCT/US12/32343 filed on Apr. 5, 2012, entitled “DISTRIBUTED MEDICAL SENSINGSYSTEM AND METHOD,” which claims the benefit of U.S. ProvisionalApplication No. 61/473,591 filed on Apr. 8, 2011 and incorporated byreference herein. The present application claims the benefit of each ofthe foregoing applications.

Innovations in diagnosing and verifying the level of success oftreatment of disease have migrated from external imaging processes tointernal diagnostic processes. In particular, diagnostic equipment andprocesses have been developed for diagnosing vasculature blockages andother vasculature disease by means of ultra-miniature sensors placedupon the distal end of a flexible elongate member such as a catheter, ora guide wire used for catheterization procedures. For example, knownmedical sensing techniques include angiography, intravascular ultrasound(IVUS), forward looking IVUS (FL-IVUS), fractional flow reserve (FFR)determination, a coronary flow reserve (CFR) determination, opticalcoherence tomography (OCT), trans-esophageal echocardiography, andimage-guided therapy. Each of these techniques may be better suited fordifferent diagnostic situations. To increase the chance of successfultreatment, health care facilities may have a multitude of imaging andsensing modalities on hand in a catheter lab during a procedure.However, each imaging modality in a catheter lab traditionally requiresits own special-purpose diagnostic equipment. For instance, an imagingmodality may require a catheter, a patient isolation module (PIM), auser control interface, a display, a specialized power unit, and aprocessing unit such as a customized personal computer. Traditionally,all of this equipment is located in the catheter room itself during aprocedure and depends on a substantial wiring infrastructure for networkconnectivity and dependable power. Physical space is typically at apremium in catheter labs and each additional imaging modality employedin a catheter lab complicates the pre-procedure setup and limits themovement of health care professionals during procedures. Additionally,known problems arise when attempting to locate portions of a diagnosticsystem outside of a catheter lab. For instance, data transmitted betweena PIM and a processing unit may degrade as the distance between the twoincreases. Similarly, traditional long-distance communication links donot support the bandwidth required for modern cardiovascular imagingtechniques.

While the existing devices and methods have been generally adequate fortheir intended purposes, they have not been entirely satisfactory in allrespects. The medical sensing systems and associated methods of thepresent disclosure overcome one or more of the shortcomings of the priorart.

SUMMARY

In one exemplary aspect, the present disclosure is directed to adistributed medical sensing system. The system includes a first bodysensing device configured to sense medical characteristics, the firstbody sensing device being located in a first sterile field and a secondbody sensing device configured to sense medical characteristics, thesecond body sensing device being located in a second sterile field, thesecond sterile field being spaced from the first sterile field. Thesystem also includes a computing device outside of the first and secondsterile fields and communicatively coupled to the first and second bodysensing devices, the computing device configured to respectively receivefirst and second medical characteristic data from the first and secondbody sensing devices, process the first and second medicalcharacteristic data, and transmit the processed first and second medicalcharacteristic data to respective first and second user interfacedevices, the first user interface being associated with the firststerile field and the second user interface device being associated withthe second sterile field.

In another exemplary aspect, the present disclosure is directed to amethod of processing medical data. The method includes receiving, at acomputing device, first and second medical characteristic data fromrespective first and second body sensing devices, the first and secondbody sensing devices being located in respective spaced first and secondsterile fields, and the computing device being outside of the first andsecond sterile fields and processing, with the computing device, thefirst and second medical characteristic data. The method also includestransmitting, with the computing device, the processed first and secondmedical characteristic data to respective first and second userinterface devices, the first user interface being associated with thefirst sterile field and the second user interface device beingassociated with the second sterile field.

In yet another exemplary aspect, the present disclosure is directed to acloud-based medical processing system. The system includes a medicalsensing device disposed in a sterile field in medical facility andconfigured to collect medical data from a patient in the sterile fieldand a site manager disposed in the medical facility coupled to a datanetwork, the site manager configured to transmit the medical dataoff-site via the data network and to receive processed medical data viathe data network. The system also includes a centralized computingdevice located off-site from the medical facility and communicativelycoupled to the site manager via the data network, the centralizedcomputing device being configured to receive medical data from the sitemanager, process the medical data, transmit processed medical data backto the site manager.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic drawing depicting a distributed medical sensingsystem according to one embodiment of the present disclosure.

FIG. 2 is a functional block diagram of an exemplary embodiment of anaspect of the distributed medical sensing system of FIG. 1,specifically, a bedside utility box.

FIG. 3 is a functional block diagram of another aspect of thedistributed medical sensing system of FIG. 1 that includes a softwareframework executing on a bedside control surface and a softwareframework executing on a centralized computer.

FIG. 4 is an illustration of a message format utilized by thedistributed medical sensing system of FIG. 1 in one embodiment of thepresent disclosure.

FIG. 5 is an illustration of a different message format utilized by thedistributed medical sensing system of FIG. 1 in another embodiment ofthe present disclosure.

FIG. 6 is an illustration of a method for synchronizing data acquisitionfrom multiple medical sensing devices in the system of FIG. 1.

FIG. 7 is a schematic drawing depicting a distributed medical sensingsystem according to another embodiment of the present disclosure.

DETAILED DESCRIPTION

For the purposes of promoting an understanding of the principles of thepresent disclosure, reference will now be made to the embodimentsillustrated in the drawings, and specific language will be used todescribe the same. It will nevertheless be understood that no limitationof the scope of the disclosure is intended. Any alterations and furthermodifications in the described devices, instruments, methods, and anyfurther application of the principles of the disclosure as describedherein are contemplated as would normally occur to one skilled in theart to which the disclosure relates. In particular, it is fullycontemplated that the features, components, and/or steps described withrespect to one embodiment may be combined with the features, components,and/or steps described with respect to other embodiments of the presentdisclosure.

FIG. 1 is a schematic drawing depicting a distributed medical sensingsystem 100 according to one embodiment of the present disclosure. Thedistributed medical sensing system 100 is a network-based distributedcomputational and storage solution for multiple modality medicalsensing. Generally, in the medical sensing system 100, medical data iscollected by network-connected sensing instruments in catheter labs butprocessed and stored in a centralized location and returned to thecatheter labs for display to and analysis by health care professionals.

In the present embodiment, the medical sensing system 100 is implementedin a health care facility with catheter labs 102, 104, and 106. Asillustrated in FIG. 1, each catheter lab 102, 104, and 106 has anassociated control room 108, 110, and 112. The catheter labs 102, 104,and 106 are sterile but their associated control rooms 108, 110, and 112may or may not be sterile depending on the requirements of a procedureand/or health care facility. Each catheter lab/control room pair may beused to perform on a patient any number of medical sensing proceduressuch as angiography, intravascular ultrasound (IVUS), forward lookingIVUS (FL-IVUS), a fractional flow reserve (FFR) determination, acoronary flow reserve (CFR) determination, optical coherence tomography(OCT), computed tomography, intracardiac echocardiography (ICE),intravascular palpography, transesophageal ultrasound, or any othermedical imaging modalities known in the art. For example, in catheterlab 102 a patient 114 may be undergoing an IVUS procedure, in which aphased-array catheter (not illustrated) is inserted into the patient'sarteries. The medical sensing system 100 includes a number ofinterconnected diagnostic tools in the catheter lab 102 and control room108 to facilitate this procedure, including a patient isolation module(PIM) 116, a bedside control surface 118, a control room control surface120, and a boom display 122. The medical sensing system 100 furtherincludes a bedside utility box (BUB) 124 in the catheter lab 102 tointerconnect these diagnostic tools and to connect to system 100. Thatis, the BUB 124 is a central hub to which the diagnostic tools in thecatheter lab 102 and control room 108 connect to the network-basedsystem 100. In one embodiment, each of the PIM 116, bedside controlsurface 118, and control room control surface 120 connect to the BUB 124with similar standardized connectors and communicate with the BUB 124using a standardized protocol. The BUB 124 will be described in greaterdetail in association with FIG. 2.

Although the BUB 124 is shown as a unit for connecting multiplediagnostic devices to the system 100, it is contemplated that in afurther embodiment each diagnostic device may include a communicationmodule that can directly access the system 100 and communicate with oneor more other devices connected to the network of system 100. Suchcommunication modules include processors and/or logic to send addressedmessages over the network and receive addresses messages from thenetwork. In one aspect the network may utilize the TCP/IP protocol fornetwork communication. Such network communications may be made over awired connection or over a wireless connection.

In the illustrated embodiment, the BUB 124 is communicatively coupled tothe patient isolation module (PIM) 116, which is, in turn, coupled to asensor device (not-illustrated) that collects medical data from apatient. In general, the PIM 116 is a patient communication system thatacts as an intermediary between the medical sensing system 100 and datacollection sensors. In some embodiments, the PIM and the BUB togethermay be considered a patient communication system. In the above exampleof IVUS, the PIM 116 is the intermediary between the BUB 124 and aphased-array catheter. For convenience purposes, the PIM 116 may hangfrom the patient table or may be placed in another location near thepatient. The PIM 116 provides power to the phased-array catheter by wayof its connection to the BUB 124. Typically, different sensoryinstruments require different amounts of power, and thus theirassociated PIMs may draw different amounts of power from the BUB 124.The PIM 116 further transmits data collected with the catheter to theBUB 124. In one embodiment, the PIM 116 includes an analog to digital(A/D) converter and transmits digital data to the BUB 124, however, inother embodiments the PIM transmits analog data to the BUB. Further, insome embodiments, the PIM 116 and BUB 124 communicate with astandardized data transmission protocol, such as Synchronous OpticalNetworking (SONET). In the illustrated embodiment, the PIM 116 and BUB124 communicate over a wired connection such as a standard copper linkor a fiber optic link but, alternatively, the PIM 116 and BUB 124 maywirelessly communicate. Although only one PIM is depicted as connectedto the BUB 124, additional PIMs associated with different medicalsensing modalities may be connected to BUB 124. Any such additional PIMsmay communicate with the BUB 124 concurrently with the PIM 116.Additionally, in some embodiments, such as those in which patient datais collected using angiography, the illustrated PIM may be replaced witha C-arm. In such embodiments, the C-arm may act as the power and dataintermediary between the actual data collection tools and the system100. U.S. Patent Application Publication No. US 2007/0232933, entitled“Component-Based Catheter Lab Intravascular Ultrasound System,”discloses a component-based IVUS system that includes a PIM and ishereby incorporated by reference in its entirety.

The bedside control surface 118 is also communicatively coupled to theBUB 124 and provides user control of the particular medical sensingmodality (or modalities) being used to diagnose the patient 114. In thecurrent embodiment, the bedside control surface 118 is a touch screenthat provides user controls and diagnostic images on a single surface.In alternative embodiments, however, the bedside control surface 118 mayinclude both a non-interactive display and separate controls such asphysical buttons and/or a joystick. In the illustrated embodiment, thebedside control surface 118 and BUB 124 communicate over a wiredconnection such as a standard copper link or a fiber optic link but,alternatively, the control surface 118 and BUB 124 may wirelesslycommunicate. Further, in some embodiments, the bedside control surface118 may be also communicatively coupled directly to the PIM 116. Thebedside control surface 118 includes an integrated processing unit todrive a graphical user interface (GUI)-based workflow presented on thetouch screen. In an exemplary embodiment, the particular GUI-basedworkflow presented by the bedside control surface 118 depends on themedical sensing modality being used to diagnose the patient 114. To thisend, the bedside control surface 118 is capable of displaying multipleGUI-based workflows, each corresponding to a particular sensor orimaging modality or simultaneous combination thereof. A softwareframework executing on the bedside control surface 118 manages themultiple workflows. This software framework will be discussed in greaterdetail in association with FIG. 3. Further, in some embodiments, thebedside control surface 118 automatically displays an appropriateworkflow based on the particular PIM connected to the BUB 124. In theevent that multiple PIMs are coupled to BUB 124, the bedside controlsurface 118 may present a user with a modality selector screen on whichthe appropriate GUI-based workflow may be selected. U.S. Pat. No.7,134,994, entitled “Multipurpose Host System For InvasiveCardiovascular Diagnostic Measurement Acquisition and Display,”discloses a multifunction diagnostic system with a multi-mode graphicaluser interface and is hereby incorporated by reference in its entirety.U.S. Patent Application Publication No. US 2008/0269572, entitled“Multipurpose Host System For Invasive Cardiovascular DiagnosticMeasurement Acquisition Including An Enhanced Dynamically ConfiguredGraphical Display,” discloses a method for dynamically switching betweencardiovascular diagnostic GUIs and is also hereby incorporated byreference in its entirety.

The control room control surface 120 in the control room 108 is alsocommunicatively coupled to the BUB 124 and, as shown in FIG. 1, isadjacent to catheter lab 102. In the illustrated embodiment, the controlroom control surface 120 and BUB 124 communicate over a wired connectionsuch as a standard copper link or a fiber optic link but, alternatively,the control surface 120 and BUB 124 may wirelessly communicate. In thecurrent embodiment, the control room control surface 120 is similar tothe bedside control surface 118 in that it includes a touch screen,integrated processing unit, and multitude of GUI-based workflowscorresponding to different medical sensing modalities. During aprocedure, however, the control room control surface 120 may be used tocarry out a different aspect of the procedure's workflow than thebedside control surface 118. In alternative embodiments, the controlroom control surface 120 may include a non-interactive display andstandalone controls such as a mouse and keyboard. Further, theprocessing unit of the control room control surface 120 may be morepowerful than the processing unit of the bedside control surface 118. Inone embodiment, the control room control surface 120 may drive the boomdisplay 122. The boom display 122 may include an array of monitors, eachcapable of displaying different information associated with a medicalsensing procedure. For example, during an IVUS procedure, one monitor inthe boom display 122 may display a tomographic view and one monitor maydisplay a sagittal view. In alternative embodiments, the boom display122 may be coupled directly to and driven by the BUB 124, the bedsidecontrol surface 118, or another network-connected device.

With reference now to FIG. 2, the BUB 124 is described in greaterdetail. FIG. 2 is a functional block diagram of an exemplary embodimentof the BUB 124. The BUB 124 includes connector sockets 130, 132, 134,and 136. In one embodiment, the sockets 130, 132, 134, and 136 may besubstantially similar (i.e. standardized), but in other embodiments,each socket may be a dedicated socket specifically configured tocooperate with a specific medical sensing system. As illustrated, theBUB 124 includes four connector sockets, but alternatively it mayinclude a greater number or fewer number of sockets. Diagnostic toolssuch as medical sensing devices and user interfaces may connect to thesockets and become part of the network-based system 100. For example,PIM 116 may connect to socket 130, bedside control surface 118 mayconnect to socket 132, and control room control surface 120 may connectto socket 134. Upon connection of a diagnostic tool to a socket, the BUB124 provides data connectivity and power to that diagnostic tool. In thecurrent embodiment, diagnostic tools such as PIM 116 are communicativelycoupled to the BUB 124 via a wired connection, but, alternatively, datatransfer may be accomplished over a fiber optic link or wirelessconnection. In the latter case, the sockets 130, 132, 134, and 136 maybe replaced with a multi-connection wireless communication module.

The BUB 124 further includes a controller 138, a switch 139, and acommunication module 140. In one some embodiments, the controller 138may be a low-power microcontroller with integrated memory andperipherals. The controller 138 is operable, among other things, toroute data from the sockets 130, 132, 134, and 136 to the communicationmodule 140 via the switch 139. The switch 139 may be a hardware-basedswitch or may be a software-based switch integrated into thecommunication module 140. In the current embodiment, the controller 138includes an analog to digital (A/D) converter which the controller mayselectively utilize based on whether data incoming from a connected PIMis analog or digital. For example, the controller 138 may convert analogdata from a PIM to digital data before it is routed to the communicationmodule. Additionally, in some embodiments, the controller 138 may beoperable to associate identifying information with the medical sensingdata when it is digitized. More specifically, the controller 138 maycreate a plurality of messages from the incoming analog data stream,where each message contains a portion of the digitized medical sensingdata and a header. The contents of these messages will be described inmore detail in association with FIGS. 4 and 5. Further, in someembodiments where the PIMs digitize the sensing data before transmittingit to the BUBs, the PIMs themselves may be operable to create thesemessages.

Further, in the event that multiple medical sensing devices are coupledto the BUB 124, the controller 138 may be operable to facilitate timesynchronization among the devices for co-registration purposes. Forinstance, in one embodiment, the controller 138 may be operable to serveas a master time server for the downstream sensing devices using anetwork-based time synchronization protocol such as the Precision TimeProtocol (PTP) or the Network Time Protocol (NTP). In anotherembodiment, the controller 138 may be operable to assign a commontimestamp to data as it arrives into the BUB 124 from a plurality ofmedical sensing devices. Further, in another embodiment, the controller138 may communicate with connected medical sensing devices using asynchronous protocol such as Synchronous Optical Networking (SONET), andmay assign timestamps to incoming medical sensing data based on themultiplexed communication. Still further, in other embodiments, the BUB124 may include a dedicated real-time clock to synchronize sampling byconnected medical sensing devices. In such an embodiment, the real-timeclock may distribute a synchronization signal to connected sensingdevices and also the controller 138 which may act as a co-registrationprocessor. In some embodiments, the real-time clock may be integratedinto the controller 138.

Further, in some embodiments, the controller 138 may be operable tomodify the medical data received from the medical sensing devices beforeit is routed to the communication module 140. For example, in someembodiments, the controller 138 may compress the data before it istransmitted over the network-based system 100. In this manner, largedata sets produced by imaging modalities such as OCT may be moreefficiently moved over system 100. In some embodiment, the controller138 may also be operable to filter incoming sensing data in some manner.As mentioned above, PIMs in system 100 may communicate directly with thesystem 100 without the use of BUBs, in which case, and compressionand/or filtering of medical data may take place in the PIMs themselvesrather than in the BUBs.

The communication module 140 in the BUB 124 is a high-speedcommunication port operable to transmit data between the diagnostictools connected to the BUB 124 and the distributed medical sensingsystem 100. In embodiments in which the system 100 includes apacket-based network, the communication module 140 is operable topacketize medical sensing data routed through (and possibly digitizedby) the controller 138, address the resulting packets, and the send thepackets out over the system 100. In the embodiments in which thecontroller 138 segments incoming sensing data into messages, thecommunication module 140 may encapsulate the messages into TCP/IPpackets for transmission over the network-based system 100. In theillustrated embodiment, the communication module 140 is an InfiniBandswitched fabric communications module, however, in other embodiments thecommunications module may be a HyperTransport communication module, afiber optic link module, a Gigabit Ethernet module, a high-speedwireless module or some other high-speed link module known in the art.Still further, in some embodiments, the above A/D conversion andpacketizing/addressing/sending functionality of the BUB 124 may beinstead embedded into a PIM, thereby negating the necessity of a BUB.

The BUB 124 further includes a medical-grade power supply unit (PSU)142. The PSU 142 provides power to the controller 138 and the diagnostictools (e.g. medical sensing devices, control surfaces) connected to thesockets 130, 132, 134, and 136. Note that the block diagram shown inFIG. 2 has been simplified for the sake of clarity. A person of ordinaryskill in the art would understand that elements of the BUB 124 may berearranged or combined and that additional elements may be added withoutchanging the functionality described herein. U.S. Provisional PatentApplication No. 61/473,625, entitled “MEDICAL SENSING COMMUNICATIONSYSTEM AND METHOD” and filed on Apr. 8, 2011, discloses a bedsideutility box that intelligently couples medical sensing-related tools andis hereby incorporated by reference in its entirety.

With reference back to FIG. 1, the distributed medical sensing system100 includes a second set of diagnostic tools in the catheter lab 104and associated control room 110, including a PIM 160, a bedside controlsurface 162, a control room control surface 164, and a boom display 166.A BUB 168 interconnects the diagnostic tools in the catheter lab 104 andcontrol room 110 and may be similar to the BUB 124. Like catheter lab102, catheter lab 104 supports any number of medical sensing modalities.For instance, a patient 170 may be undergoing an OCT procedure, in whichan OCT catheter (not illustrated) is inserted into the patient'sarteries. The OCT catheter is coupled to the PIM 160, which in turn iscoupled to the BUB 168. Similarly, the bedside control surface 162 andcontrol room control surface 164 are also connected to the BUB 168.

Further, the distributed medical sensing system 100 includes anadditional set of diagnostic tools in the catheter lab 106 andassociated control room 112, including a PIM 172 coupled to a BUB 174.Here, a patient 176 may be undergoing yet another procedure, forexample, a FFR procedure, in which a pressure sensor at the distal endof a guide wire or catheter is inserted into the patient's body.

The distributed medical sensing system 100 further includes acentralized computer 180 that is operable to manage system resources inthe network and also to process medical data collected in catheter labs102, 104, and 106. In the illustrated embodiment, the centralizedcomputer 180 is a single server-type computer, but, in otherembodiments, centralized computer may be multiple interconnectedcomputers. A software framework executing on the centralized computer180 manages the processing of medical data transmitted from the catheterlabs. This software framework will be discussed in greater detail inassociation with FIG. 3. In the current embodiment, the centralizedcomputer 180 is located in a server room 182 in the same health carefacility as the catheter labs and, as such, may be separated by tens tohundreds of meters from the catheter labs depending on the size of thehealth care facility. However, in other embodiments the centralizedcomputer 180 may be located outside of the health care facility manykilometers away, as discussed later in association with FIG. 7. Further,the processing power of the centralized computer 180 is scalabledepending on the needs of the health care facility. To this end, asillustrated in FIG. 1, the medical sensing system 100 includes an arrayof compute engines 184 communicatively coupled to the centralizedcomputer 180 in the server room 182. The number of compute engines inthe array 184 may be increased or decreased according to processingneeds. For example, a health care facility that transitions fromperforming mostly low processor intensive procedures, such as FFR, toperforming mostly processor intensive procedures, such as OCT, may addadditional compute engines to the array 184, thereby increasing theprocessing power of the centralized computer 180. In the currentembodiment, the compute engines in the array 184 are server-typecomputers clustered together in a high-speed network, however, thecompute engines may alternatively be networked processors in a massivelyparallel processor implementation. Further, in other embodiments, thecompute engine array may be implemented with general-purpose computingon graphics processing units (GPGPUs). In such a scenario, each computeengine may be an add-in card with an array of graphics processing units(GPUs) such as a Tesla GPGPU card available from Nvidia Corporation ofSanta Clara, California. When diagnostic data is transmitted to thecentralized computer 180 from the catheter labs, the computer isoperable to process the data in a parallel manner using the computeengine array 184. U.S. Patent Application Publication No. US2009/0093980, entitled “Real Time SD-OCT With Distributed Acquisitionand Processing,” discloses a system for processing medical data inparallel and is hereby incorporated by reference in its entirety. AndU.S. patent application Ser. No. 12/978,344, entitled “Integrated SystemArchitectures and Methods of Use,” discloses an integrated system forcollecting and processing medical data and is hereby incorporated byreference in its entirety.

The diagnostic system 100 further includes a storage array 186 coupledto the centralized computer 180. In one embodiment, the storage array186 is configured to store patient data in a manner conforming toDigital Imaging and Communications in Medicine (DICOM) standards. Forexample, the storage array 186 may archive patient images collected bythe various medical sensing modalities in the catheter labs 102, 104,and 106 Like the compute engine array 184, the storage array 186 isscalable to meet the needs of the health care facility. In the currentembodiment, the storage array 186 is a storage area network ofinterconnected storage devices, but alternatively it may be an array ofhard disks in the centralized computer 180, an array of tape drives, orsome other scalable storage solution.

The BUBs 124, 168, and 174 are communicatively coupled to thecentralized computer 180 by communication interconnects 188, 190, and192. In the current embodiment, the communication interconnects areInfiniBand links but alternatively may be another type of high-speedinterconnect such as HyperTransport links, or may be high-speed wirelesscommunication interconnects. The BUBs 124, 168, and 174, centralizedcomputer 180, and other network devices in the diagnostic system 100 maycommunicate over the communication interconnects using a secureprotocol, such as Transport Layer Security (TLS) over TCP/IP.Additionally, to help facilitate co-registration of multi-modalitysensing data the BUBs 124, 168, and 174 may communicate with thecentralized computer 180 using a synchronized protocol such as SONET.Further, to reduce wiring clutter in the catheter labs, theinterconnects 188, 190, and 192 may extend toward their respectivecatheter lab underneath the floor in a cable trench and break out of thefloor in the labs through cabling ports near their respective BUBs 118,168, and 174, and make a single connection to the BUBs.

Further, a doctor or other health professional may access the medicalsensing system 100 through a networked computing device 194. Thecomputing device 194 may access patient information stored on thestorage array 186, or, in some embodiments, monitor one or more on-goingprocedures in the catheter labs in real time. The computing device 194may access the system 100 through a wired or wireless network connectionusing a known communication protocol such as Ethernet or IEEE 802.11. Insome embodiments a network bridge may be required to interconnect astandard Ethernet-based network and a high-speed network, such as theabove-described InfiniBand network. In the current embodiment, thecomputing device 194 is a laptop used by a doctor in a doctor's office,but in other embodiments the computing device may be a PC, smartphone,tablet computer, or other device with a network connection locatedinside or outside of the health care facility. Additionally, the medicalsensing system 100 may be communicatively coupled to a hospitalinformation system (HIS) 196 that manages the administrative, financialand clinical aspects of the health care facility, and alsocommunicatively coupled to a picture archive and communication system(PACS) of the health care facility. In some embodiments, the centralizedcomputer 180 may be operable to request patient workflow data from DICOMservers on the HIS 196. For instance, the centralized computer 180 mayuse the DICOM patient data to schedule procedures in the catheter labsand also customize workflows for particular patients. The connections tothe HIS 196 and PACS may be implemented using a network bridge or someother networking device.

With reference now to FIG. 3, the software frameworks executing in thedistributed medical sensing system 100 are described in greater detail.FIG. 3 is a functional block diagram of a portion of the system 100,including the software framework executing on the bedside controlsurface 118 and the software framework executing on the centralizedcomputer 180. The left portion of FIG. 3 illustrates one configurationof catheter lab 102, in which two PIMSs, an angiography system, and thebedside control surface 118 are connected to BUB 124. Specifically, thePIM 116, a PIM 200, and an angiography system 202 are connected to theBUB 124. In the current embodiment, the PIMs 116 and 200 and angiographysystem 202 are used for different medical sensing modalities, and thusthe associated workflows are different. However, in the exemplaryembodiment, a health care professional may control all three medicalsensing workflows from the bedside control surface 118. In more detail,the bedside control surface 118 includes a software framework in whichuser interface (UI) applications for each medical sensing modality mayexecute within a UI application layer 204. The software framework alsoincludes a software stack 206 that executes underneath and supports thelayer of UI applications 204. In the current embodiment, the softwarestack 206 exposes a set of application programming interfaces (APIs)with which the applications in the UI application layer 206 may call toaccess system resources such as a look-and-feel toolbox andcommunication infrastructure.

Using components of the look-and-feel toolbox, each UI application 204may present a GUI that gives a user control over an imaging or signalingmodality workflow and also presents imaging or signaling data collectedfrom the associated PIM and processed by the centralized computer 180.Further, co-registration UI applications may present and/or combineprocessed image or signaling data from multiple modalities. Forinstance, a UI application may display an electrocardiogram (ECG) waveadjacent to IVUS imaging data or may display an IVUS image overlaid withborders that were previously drawn on an OCT image. Such co-registrationUI applications may harness the parallel processing power of thecentralized computer 180 and acquire data from two medical data streamssimultaneously to facilitate a real time co-registration workflow. In anexemplary embodiment, additional UI applications may be added to theapplication layer 204 to support new medical sensing modalities orco-registration techniques developed after the control surface 118 hasbeen deployed. Further, the API-based software framework allows the UIapplications 204 to be independent of the software stack 206 and thuswritten by third parties to control a custom workflow. As mentionedabove, in some embodiments, the bedside control surface 118 mayautomatically select the appropriate UI application (and thus theappropriate workflow) based on the particular PIM connected to the BUB124. In the event that multiple PIMs are coupled to BUB 124, as isillustrated in FIG. 3, the bedside control surface 118 may present auser with a modality selector screen on which the desired GUI may beselected.

As described in association with FIG. 1, the BUB 124 is communicativelycoupled to the centralized computer 180 via the communicationinterconnect 188. Like the bedside control surface 118, the centralizedcomputer 180 includes an API-based software framework in whichprocessing applications associated with medical sensing modalities mayexecute. In particular, the centralized computer 180 includes a softwarestack 208 that executes underneath and supports a layer of processingapplications 210. Processing applications in the application layer 210may correspond to a medical sensing modality in use in the health carefacility and processes all data for that particular sensing modality.For example, every PIM in the health care facility that collects IVUSdata may send the data over the system 100 to an IVUS processingapplication in the application layer 210 on centralized computer 180.The IVUS processing application may interpret the IVUS data and sendimage data back over the system 100 to IVUS UI applications on thebedside control surfaces for display. Further, in some embodiments, theapplication layer 210 may include co-registration applications, in whichmedical sensing data from a plurality of medical sensing devices areco-registered and returned to co-registration UI applications on controlsurfaces. To support such co-registration applications, in oneembodiment, the software stack 208 may expose one or more timesynchronization APIs for use by the applications. For instance, thecentralized computer 180 may act as a master clock using the NTP or PTPprotocols where each BUB in the system 100 is a client or,alternatively, the computer 180 may include a dedicated real-time clock.In either case, co-registration applications in the application layer210 may have access to synchronization data via APIs exposed by thesoftware stack 208. U.S. Provisional Patent Application No. 61/473,570,entitled “MULTI-MODALITY MEDICAL SENSING SYSTEM AND METHOD” and filed onApr. 8, 2011, discloses a computing resource with a similar modularAPI-based software framework capable of processing multi-modalitymedical sensing data and is hereby incorporated by reference in itsentirety.

The software stack 208 executing on the centralized computer 180 isoperable to utilize the parallel processing power of the compute enginearray 184. As such, the processing applications 210 can processsignaling and imaging data from multiple on-going proceduresconcurrently. In this regard, in some embodiments, the software stack208 may intelligently make use of the computing resources available tocentralized computer 180 by identifying generic computing tasks commonto concurrently executing processing applications. For example, thesoftware stack 208 may determine that two processing applications(associated with different modalities) each need to perform filtering,image processing, and scan conversion processes on incoming sensingdata. Once these common tasks are identified, the software stack 208 mayutilize a library of parallel algorithms to process these tasksconcurrently.

Further, after processing medical sensing data for a procedure, theprocessing applications 210 may store the data in the storage array 186.Additionally, the processing applications 210 may manage the workflowsfor the associated UI applications installed on the control surfaces. Inan exemplary embodiment, additional processing applications may be addedto the application layer 210 to support new medical sensing modalitiesand new UI applications on the control surfaces. For example, to supporta new medical sensing modality, a third party may develop a newcatheter-based sensor, new PIM, new UI application, and new processingapplication. In such a scenario, the new PIM may connect to BUB 124, thenew UI application may be installed onto the existing control surface118 and call the APIs exposed by the software stack 206, and the newprocessing application may be installed onto the centralized computer180 and call the APIs exposed by the software stack 208.

With reference now to FIG. 4, illustrated is a message format utilizedby the distributed medical sensing system 100 in one embodiment of thepresent disclosure. As mentioned above, in some embodiments, a BUB mayconvert incoming medical sensing data into a plurality of messagescontaining digitized sensing data and associated identifyinginformation. FIG. 4 illustrates an example message 212. The message 212includes a header 214 and a payload 216. The payload 216 includesdigitized medical sensing data collected with the medical sensingdevices in system 100. The header 214 includes information associatedwith the sensing data in the payload 216. In more detail, the headerincludes a patient info portion and a data info portion, where theformer generally includes information about the patient and procedurefrom which the medical sensing data came and the latter generallyincludes information about the data characteristics. More specifically,in the illustrated embodiment, the patient info portion of header 214includes blocks 218, 220, 222, and 224 that respectively containprocedure date and time, procedure location (e.g. health care facility,catheter lab, etc), patient identification (e.g. name, social securitynumber, date of birth, etc), and doctor identification (e.g. name,license number, etc). In some embodiments, the patient info portion mayadditionally contain security access information that limits where or bywhom the sensing data may be viewed. As illustrated, the data infoportion of the header 214 includes blocks 226, 228, 230, 232, and 234that respectively contain a timestamp, modality of the sensing data,analog to digital conversion information, compression info, and aworkflow ID. In one embodiment, the timestamp in block 226 maycorrespond to the point in time the data in payload 216 was collected.This timestamp may be used to facilitate co-registration of the sensingdata with data of a different modality. The modality information inblock 228 may include the modality of the data in payload 216 (e.g.IVUS, OCT, etc) and, in some embodiments, may also include theinformation about the specific medical sensing device with which thedata was taken. The A/D information in block 230 may include informationpertaining to the manner in which the sensing data in payload 216 wasdigitized, for example, sampling rate information and error correctioninformation. The compression information in block 232 may include a flagindicating whether the data in payload 216 is compressed and, ifnecessary, the type of compression with which it is compressed. Finally,the workflow identification in block 234 may identify the workflow inwhich the data in payload 216 was collected. In some embodiments, thisinformation may enable the centralized computer 180 to determine whichprocessing application should process the data in payload 216. And itmay enable a control surface in a catheter lab to determine which UIapplication should display the data once it is processed. The examplemessage 212 is only one embodiment of a message that may be utilized insystem 100, and, in other embodiments, the system 100 may utilize adifferent message format that includes additional and/or differentinformation.

Further, in some embodiments, when a BUB first establishes a dataconnection with the centralized computer 180 to send medical sensingdata, it may initially send one or more messages containing informationsimilar to message 212. But, after the data connection has beenestablished, the BUB may send messages with a smaller header containingonly essential information such as a connection identifier and atimestamp. In such a scenario, the centralized computer 180 may storethe remainder of the header info and associate it with the connectionidentifier. In this manner, medical sensing data may be more efficientlytransmitted over the network-based system 100. The shortened message 236is only one embodiment of a message that may be utilized in system 100,and, in other embodiments, the system 100 may utilize a differentshortened message format that includes additional and/or differentinformation. Or, the system 100 may not use a shortened message formatat all.

With reference now to FIG. 5, illustrated is a different message formatutilized by the distributed medical sensing system 100 in anotherembodiment of the present disclosure. FIG. 5 illustrates an examplemessage 235. The message 235 includes a header 236 and a payload 237.Like the payload 216 of message 212, the payload 237 includes digitizedmedical sensing data collected with the medical sensing devices insystem 100. However, the header 236 associates different informationwith the sensing data than the header 214 of message 212. The header 236includes blocks 238 and 239 that respectively hold a unique universalidentifier (UID) and a timestamp (or sequence number). Generally, theUID in block 238 is used to associate the data in payload 237 with dataacquisition information stored in the centralized computer 180. In moredetail, during the preparatory stages of a data acquisition workflow,the centralized computer 180 may allocate a UID and associate it with astorage location in the storage array 186 and a processing chain in thecompute engine array 184. Further, the centralized computer 180 may pushthe UID down to the medical sensing tools that will be used in theprocedure. Thus, when data acquisition starts, the BUB (or in someembodiments, the PIM) may tag the collected data with the UID byinserting it into the message header. In this manner, identifyinginformation about the data such as patient identify, doctor identify,procedure date/time, location, data modality, data compression, PIMidentify, catheter identify may be centrally stored on the centralizedcomputer rather than stored in a message. Further, in some embodiments,the centralized computer 180 may allocate a different UID to associatewith a processed version of medical sensing data. A network-connecteduser interface, such as bedside control surface 118, may then access theprocessed data using the associated UID. Still further, if one set ofmedical sensing data has multiple processed versions, each processedversion may be associated with a different UID. In this manner,different user interfaces may specifically access different processedversions depending on the display capabilities of the user interface.

With reference now to FIGS. 1, 2, and 3, in operation, the distributedmedical sensing system 100 is a distributed computational and storagesolution for multiple modality medical sensing. Generally, in system100, medical signaling and imaging data is collected by sensinginstruments in catheter labs but processed and stored in a centralized,remote location and returned to the catheter labs for analysis by healthcare professionals.

For example, if the patient 114 is to undergo an IVUS procedure incatheter lab 102 a technician or doctor connects a phased-array catheterand associated PIM to the BUB 124 before the procedure. Upon connection,the bedside control surface 118 automatically displays the GUIassociated with the IVUS procedure so a technician may start the IVUSworkflow. As mentioned above, the centralized computer 180 may customizethe IVUS workflow based on patient data retrieved from DICOM servers inthe HIS 196. When the patient is ready, a health care provider insertsthe sterile catheter into the patient's arteries and begins gatheringtissue characteristic data. The PIM sends the data to the BUB 124 which,in turn, routes the data to the centralized computer 180 in the remoteserver room 182. In the centralized computer 180, an IVUS processingapplication in the application layer 210 interprets the tissue data andtransforms it into IVUS image data. To decrease turn-around time, thesoftware stack 208 may split up the workload and process the data inparallel using multiple compute engines in the array 184. Afterprocessing is complete, the processing application may store the imagedata in the storage array 186. The centralized computer 180 returns theprocessed image data to the control room 102 and the BUB 124 routes itto the bedside control surface 118 and the control room control surface120. An IVUS UI application in the application layer 204 presents theimage data to the user of the bedside control surface 118 as part of theIVUS workflow. At the same time, an IVUS UI application in the controlroom control surface 120 may present the processed diagnostic data in adifferent manner to a user of the control room control surface. Thecontrol room control surface 120 may also drive the image data to theboom display 122. In this manner, the health care professionals carryingout the IVUS procedure may simultaneously execute multiple tasks withinthe workflow, or simultaneously execute multiple workflows. Forinstance, a doctor manipulating the catheter may view a tomographicperspective of the procedure on the boom display 122 while a bedsidetechnician controls the workflow from the bedside control surface 118and a second technician in the control room 108 traces borders on theimage data in real time using the control room control surface 120. Inthe case of the border tracing workflow, the centralized computer 180may selectively provide the control room control surface 120 with IVUSimage frames on which borders may be drawn. The control room controlsurface 120 may then send the centralized computer 180 the annotatedIVUS images so that they may be archived. In this manner, a clinicianoperating the control room control surface may simultaneously andindependently work on the medical sensing data being acquired in theadjacent catheter lab.

While the health care professionals perform the IVUS procedure in thecatheter lab 102, the medical sensing system 100 may simultaneouslysupport an OCT procedure in the catheter lab 104. In such a case, whenthe patient 170 is ready, a doctor connects an OCT catheter andassociated PIM 160 to the BUB 168, the bedside control surface 162presents the OCT workflow GUI, and the doctor begins collecting data.The BUB 168 routes the raw OCT data to the centralized computer 180where an OCT processing application in the application layer 210interprets the data. To process the OCT data efficiently, the softwarestack 208 assigns the data to compute engines not already processingdata for the concurrent IVUS procedure. After the OCT image data hasbeen processed, it is stored in the storage array 186 and returned tothe BUB 168 in the catheter lab 104, where it is routed to the controlsurfaces 162 and 164. OCT UI applications executing in the applicationlayers 204 present the image data to the doctor and techniciansperforming tasks in the OCT workflow.

Further, the medical sensing system 100 may simultaneously support athird procedure in catheter lab 106, such as an FFR procedure, in whichFFR data is sent to centralized computer 180 for processing by an FFRprocessing application. Although FIG. 1 depicts only three catheterlabs, one of ordinary skill in the art would recognize that the medicalsensing system 100 may simultaneously support additional diagnosticprocedure in additional catheter labs. Also, additional or differentdiagnostic procedure may be performed in the catheter labs 102, 104, and106. For instance, three OCT procedures may be simultaneously performedin the catheter labs 102, 104, and 106, whereby the centralized computer180 may process the OCT data from the labs in parallel using the computeengine array 184.

Additionally, multiple medical sensing modalities may be usedconcurrently in a single catheter lab. For instance, clinicians incatheter lab 102 may carryout a multimodality workflow that utilizesboth IVUS and OCT imaging data. In such a case, a UI application on thebedside control surface 118 may coordinate the collection of data withtwo catheters. PIMs associated with the two catheters may be active andtransmitting data to the centralized computer 180 where aco-registration processing application may interpret and co-register theimage data. The co-registered data may then be returned to catheter lab102 and a co-registration UI application may display synchronized imageson the bedside control surface 118 and, if desired, boom display 122.

As mentioned above, the distributed medical sensing system 100 mayinclude time synchronization elements to facilitate co-registration ofdata from different modalities. Temporal co-registration may beaccomplished in different ways using system 100. First, timesynchronization among devices in system 100 may be accomplished withnetwork time synchronization using a network-based time synchronizationprotocol such as Precision Time Protocol (PTP) or Network Time Protocol(NTP). In such a case, the centralized computer 180 may act as a(grand)master clock where the BUBs in the system are the clients. Inturn, the BUB may act as master time servers for sensing and controldevices downstream of them in the catheter labs. Through this protocol,all medical sensing devices may be synchronized to within 100 μs orbetter. Data acquisition may then be controlled (i.e. started/stopped)at a pre-determined time by workflows executing on control surfaces. Inthis scenario, data is collected and time-stamped by each medicalsensing device and forwarded through the system 100 to the centralizedcomputer 180 for processing and archival. By having a timestamp based ona mutual clock, any sample from one data set may be matched temporallywith a sample from another, even where the sample periods are not commonand sampling clocks drift from the mutual network clock. As an example,in this embodiment, clinicians in catheter lab 102 may carry out amultimodality workflow by using a Forward-Looking Intracardiac Echo(FLICE) device and functional measurement pressure wires, where each iscoupled to BUB 124 via their associated PIMs. In this case, BUB 124 is alocal time server and each of these sensing devices is a time protocolclient. After the catheters are positioned in the patient 114, therespective devices collect, timestamp, and forward data to the BUB 124,where it is forwarded to the centralized computer 180. A co-registrationprocessing application in the application layer 210 reassembles the datainto matched sets according to timestamps (i.e. matches FLICE frames topressure samples) and sends the co-registered, processed data to thebedside control surface 118 for display. A UI application in theapplication layer 204 renders the pressure waves and moving FLICE imageson the screen.

In other embodiments, rather than have the medical sensing devicesthemselves apply timestamps, the BUBs in system 100 may apply thetimestamp at receipt of the sensing data before forwarding it on to thecentralized computer for processing. In this manner, it is possible toget time-stamped data without requiring the medical sensing devices toact as a time protocol client. This is advantageous for legacy devices,third-party devices without network time protocol support, and devicesthat only transmit analog data to the BUBs. Further, in otherembodiments, the centralized computer 180 may timestamp data as itarrives from medical sensing devices on the system 100.

Second, time synchronization among devices in medical sensing system 100may be accomplished with real-time clocks driving synchronized samplingby medical sensing devices. As mentioned above, in some embodiments, theBUBs may include a dedicated real-time clock. In this scenario,synchronization signals from this clock may be distributed to themedical sensing devices coupled to the BUB and also a co-registrationprocessor (e.g. the controller 138 in BUB 124 or the centralizedcomputer 180). The synchronization signal may be carried by anindividual conductor from the BUBs to the medical sensing devices or maybe bundled into a system cable that carries network signals and power tothe sensing devices. This synchronization signal may be a traditional,square-wave clock signal or a periodic, edge-based synch signal. Ineither case, the signal may be divided down or used as-is to produce asynchronization event on all sensing devices with a period less than orequal to the desired synchronization accuracy. A timestamp consisting ofthe enumerated counts of synchronization events may then be applied tocollected data by each of the BUB-connected devices to identify aparticular instant in time on a common time-base.

With reference now to FIG. 6, illustrated is a method for synchronizingdata acquisition from multiple medical sensing devices coupled to theBUB 124. Specifically, FIG. 6 illustrates time synchronization in anembodiment in which the controller 138 in BUB 124 acts as aco-registration processor for medical sensing devices 240 and 242coupled to the BUB 124. In this embodiment, the BUB 124 includes areal-time clock that sends a synchronization signal to both thecontroller 138 and the sensing devices 240 and 242. During ainitialization phase 244, the controller 138 oversees the setup ofnetwork connections to the medical sensing devices 240 and 242 connectedto the BUB 124 and ensures they are in a state to begin synchronous dataacquisition. Specifically, during the initialization phase 244, thecontroller 138 initially sends network messages to zero each sensingdevice's timestamp. Then, during a synchronization phase 246, thecontroller 133 requests timestamps from each device a number of times insynchronization with the synch signal until the sensing devices 240 and242 are consistently reporting the same timestamp. If a timestampreceived from one device is behind another (due to network congestionwhen sending the zero command or the request time command), thecontroller 138 will command the slower device to advance its timestampby the difference between the two timestamps. This process is repeateduntil sensing devices 240 and 242 consistently report the sametimestamp. At that time, a common time-base is established. Inembodiments using a broadcast-capable network, the need to adjusttimestamps on any sensing device may seldom be seen. Next, during a dataacquisition phase 248 and after a common timestamp has been establishedbetween sensing devices 240 and 242, controller 138 sends a message tostart synchronized data acquisition at a common time in the future. Thisstart time is chosen to allow enough time for each sensing device toprepare for full data-rate acquisition in synchronization with thereal-time clock. When the start time arrives, the sensing devices 240and 242 begin collecting, time-stamping, and forwarding data to thecontroller 138.

Third, time synchronization among sensing devices in medical sensingsystem 100 may be accomplished with the use of a synchronous networksuch as SONET. As mentioned above, in some embodiments, the centralizedcomputer 180 may communicate with the BUBs using the SONET protocol, andthe BUBs, in turn, may communicate with the medical sensing devicescoupled to them using SONET. In such a scenario, time-divisionmultiplexing (TDM) is used to synchronize data sent from the BUBs to thecentralized computer 180. For example, if two sensing devices arecoupled to BUB 124, the communication channel from the BUB 124 to thecentralized computer 180 may be divided into timeslots, where data fromeach sensing device is assigned one or more timeslots. If one of thesensing devices generates more data than the other per unit time (e.g.FFR vs. OCT), the data-heavy device may be dynamically assigned agreater number of timeslots. In any case, the medical sensing devicesare each connected to the BUB 124 over a synchronous link with athroughput that is a divisor of the throughput of the communicationinterconnect 188 from the BUB 124 to the centralized computer 180. Basedon clinician input and known medical sensing device characteristics(possibly determined dynamically), the BUB 124 may allocate timeslots toeach device according to the workflow in the catheter lab 102. The BUB124 may relay this timeslot configuration to the centralized computer,where it may be stored for future reference. After the medical sensingdevices have been assigned timeslots as above, the devices beginstreaming data to the BUB 124. At the co-registration begin time (auser-defined “start” point, or occurrence of some other identifiedcondition), each TDM packet and all sub-channels of those packets, areassigned a monotonically increasing timestamp based on the packetnumber, packet size, number of channels configured in the timeslot map,and communication interconnect 188 bandwidth. Synchronized timestampsmay then be applied to the data by the BUB 124 or the centralizedcomputer 180.

Additionally, in some embodiments, the distributed medical sensingsystem 100 may be used to temporally co-register data acquired atsubstantially different times. In such embodiments, the centralizedcomputer 180 may rely on a highly accurate time server which retains itsfrequency with high precision over long periods of time. Internet timeservers using atomic clocks as master clocks commonly provide thisfunctionality. The centralized computer 180 may alternatively have itsown atomic clock in the system 100. In general, to co-register data setsacquired at different times, the timestamp of the first sample of eachdata set is subtracted from each sample, leaving only a delta timebetween samples. The two data sets may then be treated as if they wereacquired simultaneously. For example, in one embodiment, OCT data mayfirst be collected from the patient 114 in catheter lab 102, processedby centralized computer 180, and stored in data store array 186. Then,at a later time, IVUS data may be collected from the patient 114,processed by centralized computer 180, and stored in data store array186. In each case, the data may be time-stamped using one of the abovedescribed methods. In another embodiment, this commonfrequency-controlled clock may be used to co-register sensing data fromtwo sequential acquisitions during the same procedure. For example, thecommon clock may be used to co-register data from a pre-stent IVUSpullback and data from a post-stent IVUS pullback.

To co-register the collected and time-stamped OCT and IVUS data, aco-registration processing application in the application layer 210 onthe centralized computer 180 may retrieve the data sets from the datastore array 186 and subtract the first timestamp of each data set fromall other timestamps in the sets. The co-registration processingapplication, through interaction with a clinician via a UI applicationon the bedside controller 118 or through an automatic location detectionalgorithm, chooses a data frame in each of the data sets that correspondto the same physical location in patient 114. The timestamps of thesetwo frames are then subtracted, which gives an offset of timestampsbetween the data sets. Finally, this offset is subtracted from alltimestamps in the data set with the greater value at the matched frame,so that the timestamps corresponding to the matched frames in each stackare equal. Additionally, in other embodiments, a similar method may beutilized to co-register archived data with data collected in real-time.

Further, the network-centric design of the distributed medical sensingsystem 100 may be advantageously utilized to perform any number of“telemedicine” tasks. For example, medical sensing data collected incatheter lab 102 and processed by the centralized computer 180 may beaccessed by any number of network-connected devices outside of catheterlab 102 for training purposes, consultation purposes, etc. In additionto enabling remote, non-interactive viewing, the system 100 may provideremote interactive access to ongoing workflows. For instance, aconsulting doctor in a remote health care facility may monitor acatheterization procedure and take control of the workflow if the needarises. In another example, a clinician performing an IVUS procedure incatheter lab 102 may request that a clinician performing a differentprocedure in catheter lab 104 momentarily take control of the IVUSworkflow or ask for a second opinion of an IVUS image returned by thecentralized computer 180. In such a case, the centralized computer 180would direct the boom display 166 and control surface 162 in catheterlab 104 to temporarily display the IVUS workflow from catheter lab 102.Interactivity may be further expanded such that an entire workflow maybe controlled by a network-connected clinician outside of the catheterlab. For example, robotic data collection tools may be connected to thesystem 100 through a BUB or other networked device. In such a scenario,the system 100 may provide remote control functionality to a remoteclinician through a graphical user interface with appropriaterobot-centric controls.

Referring now to FIG. 7, shown is a schematic drawing depicting adistributed medical sensing system 250 according to another embodimentof the present disclosure. The medical sensing system 250 is similar tothe medical sensing system 100 shown in FIG. 1 and may be alternativelyimplemented in the health care facility with the catheter labs 102, 104,and 106 Like medical sensing system 100, medical sensing system 250utilizes centralized computing and storage to support diagnosticprocedures in the catheter labs, however, in system 250 the computingand storage resources are located off-site (i.e. in the “cloud”).

In more detail, the medical sensing system 250 includes a site manager252 stored in the centrally located server room 182. In an exemplaryembodiment, the site manager 252 is a computer communicatively coupledto the BUBs 124, 168, and 174 via the communication interconnects 188,190, and 192 and is operable to coordinate use of cloud resources andremote management. More specifically, the site manager 252 is operableto schedule data processing jobs for the medical sensing workflows inthe catheter labs 102, 104, and 106. To mitigate against slower orun-reliable cloud networks, the site manager 252 may be configured totemporarily store data acquired locally before forwarding the data tothe centralized computer 254. When the site manager 252 receivesacknowledgement of successful storage of the data in the storage array258 and/or receipt of processed data from the compute engine 256, thesite manager may then safely discard the temporary local copy of thedata. Further, in some embodiments, the site manager 252 may beconfigured to encrypt the unprocessed diagnostic data according to DICOMstandards before sending it offsite for processing.

The medical sensing system 250 further includes a centralized computer254, an array of compute engines 256, and a storage array 258, allstored in an off-site processing center 260. The off-site processingcenter 260 may be remote from the health care facility, in that it maybe located in different city, state, or country. The centralizedcomputer 254, array of compute engines 256, and storage array 258 arescalable to meet the needs of the processing center 260 and may besimilar to the centralized computer 180, array of compute engines 184,and storage array 186 of FIG. 1. The computing resources in processingcenter 260 may be generally more powerful than those depicted in FIG. 1because processing center 260 may serve the processing needs of manyhealth care facilities. Like the centralized computer 180, thecentralized computer 254 includes a software framework with a softwarestack similar to software stack 208 and a processing application layersimilar to application layer 210. The processing application layer incentralized computer 254 thus includes processing applicationscorresponding to the types of medical sensing modalities performed atthe health care facilities serviced by the processing center, and alsomay include co-registration processing applications used by the healthcare facilities. In some embodiments, the processing center 260 may bemanaged independently of the health care facilities it services andhealth care facilities may be charged for the use of the processingcenter. In one embodiment, health care facilities may be charged perprocedure for the use of the computing resources in the processingcenter 260.

The centralized computer 254 in the processing center 260 iscommunicatively coupled to the site manager 252 via a communicationinterconnect 262. The communication interconnect 256 is a long-distancebroadband connection operable to quickly transfer large datasets fromthe health care facility to the processing center 260 and back. In oneembodiment, the communication interconnect 256 may be a 10 GigabitEthernet link or, but in other embodiments it may be another type oflong distance broadband connection such as an ATM over SONET (OC-12 orbetter) link.

Although illustrative embodiments have been shown and described, a widerange of modification, change, and substitution is contemplated in theforegoing disclosure and in some instances, some features of the presentdisclosure may be employed without a corresponding use of the otherfeatures. For example, in some embodiments, the centralized computingresources of the medical sensing system 100 may be used to processnon-cardiovascular diagnostic data such data from cranial or peripheralarteries, as well as data from non-vascular body portions. Further, thesystem 100 may be used to collect and process MRI data, or may beutilized in computer assisted surgery (CAS) applications. It isunderstood that such variations may be made in the foregoing withoutdeparting from the scope of the present disclosure. Accordingly, it isappropriate that the appended claims be construed broadly and in amanner consistent with the scope of the present disclosure.

1. A distributed medical sensing system, comprising: a first bodysensing device configured to sense medical characteristics, the firstbody sensing device being located in a first sterile field; a secondbody sensing device configured to sense medical characteristics, thesecond body sensing device being located in a second sterile field, thesecond sterile field being spaced from the first sterile field; and acomputing device outside of the first and second sterile fields andcommunicatively coupled to the first and second body sensing devices,the computing device configured to respectively receive first and secondmedical characteristic data from the first and second body sensingdevices, process the first and second medical characteristic data, andtransmit the processed first and second medical characteristic data torespective first and second user interface devices, the first userinterface being associated with the first sterile field and the seconduser interface device being associated with the second sterile field. 2.The distributed medical sensing system of claim 1, including a datastore located outside of the first and second sterile fields, data storebeing configured to store at least the processed first and secondmedical characteristic data.
 3. The distributed medical sensing systemof claim 1, wherein the first body sensing device includes a catheterconfigured to enter into a vessel of a body.
 4. The distributed medicalsensing system of claim 3, wherein the catheter includes a sensorconfigured for one of intravascular ultrasound (IVUS) imaging, opticalcoherence tomography (OCT), and a fractional flow reserve (FFR)determination
 5. The distributed medical sensing system of claim 1,wherein the first and second sterile fields are within differentprocedure rooms; and wherein the computing device is disposed in adifferent room than either of the first and second sterile fields. 6.The distributed medical sensing system of claim 5, wherein the computingdevice is located in a different building from the first and secondsterile fields.
 7. The distributed medical sensing system of claim 5,wherein the first and second sterile fields are in different buildingsfrom each other.
 8. The distributed medical sensing system of claim 5,wherein the first and second sterile fields are in the same building;and further including a site manager communicatively interposed betweenthe first and second body sensing devices and the computing device, thesite manager being operable to manage data transmission between thefirst and second body sensing devices and the computing device.
 9. Thedistributed medical sensing system of claim 1, wherein the first andsecond medical characteristic data are associated with different sensingmodalities.
 10. The distributed medical sensing system of claim 1,wherein the computing device includes a scalable array of computeengines.
 11. The distributed medical sensing system of claim 1, whereinthe computing device is operable to process the first and second medicalcharacteristic data concurrently.
 12. The distributed medical sensingsystem of claim 1, wherein the data store includes a scalable array ofdata storage units.
 13. A method of processing medical data, comprising:receiving, at a computing device, first and second medicalcharacteristic data from respective first and second body sensingdevices, the first and second body sensing devices being located inrespective spaced first and second sterile fields, and the computingdevice being outside of the first and second sterile fields; processing,with the computing device, the first and second medical characteristicdata; and transmitting, with the computing device, the processed firstand second medical characteristic data to respective first and seconduser interface devices, the first user interface being associated withthe first sterile field and the second user interface device beingassociated with the second sterile field.
 14. The method of processingmedical data of claim 13, further including storing the processed firstand second medical characteristic data in a data store outside of thefirst and second sterile fields.
 15. The method of processing medicaldata of claim 13, wherein the processing the first medicalcharacteristic data is performed concurrently with the processing thesecond medical characteristic data.
 16. The method of processing medicaldata of claim 13, wherein the processing the first and second medicalcharacteristic data is performed by a scalable array of compute engines.17. The method of processing medical data of claim 13, wherein the firstand second medical characteristic data are associated with differentsensing modalities.
 18. The method of processing medical data of claim13, wherein the processing the first and second medical characteristicdata includes processing the first medical characteristic data with afirst processing application associated with a first sensing modalityand processing the second medical characteristic data with a secondprocessing application associated with a second sensing modalitydifferent from the first sensing modality.
 19. The method of processingmedical data of claim 13, wherein the receiving the first and secondmedical characteristic data includes communicating with a site manageroperable to manage the receiving.
 20. The method of processing medicaldata of claim 13, wherein the receiving the first and second medicalcharacteristic data includes receiving data collected by introducing acatheter into a vessel of a body.
 21. The method of processing medicaldata of claim 20, wherein the first and second medical characteristicdata includes at least one of intravascular ultrasound (IVUS) imagingdata, optical coherence tomography (OCT) data, and fractional flowreserve (FFR) data.
 22. The method of processing medical data of claim13, wherein the storing the processed first and second medicalcharacteristic data includes storing the data in a scalable storagearray.
 23. The method of processing medical data of claim 13, whereinthe computing device is located in a different building from the firstand second sterile fields.
 24. The method of processing medical data ofclaim 13, wherein the first and second sterile fields are in differentbuildings from each other.
 25. The method of processing medical data ofclaim 13, wherein the processing the first and second medicalcharacteristic data includes transforming the first and second medicalcharacteristic data into respective first and second human-readable datarepresentative of the first and second medical characteristic data. 26.A cloud-based medical processing system, comprising, a medical sensingdevice disposed in a sterile field in medical facility and configured tocollect medical data from a patient in the sterile field; a site managerdisposed in the medical facility coupled to a data network, the sitemanager configured to transmit the medical data off-site via the datanetwork and to receive processed medical data via the data network; anda centralized computing device located off-site from the medicalfacility and communicatively coupled to the site manager via the datanetwork, the centralized computing device being configured to receivemedical data from the site manager, process the medical data, transmitprocessed medical data back to the site manager.
 27. The cloud-basedmedical processing system of claim 26, wherein the site manager isconfigured to temporarily store the medical data before transmitting itto the centralized computing device.
 28. The cloud-based medicalprocessing system of claim 26, wherein the site manager is configured toencrypt the medical data before transmitting it to the centralizedcomputing device.
 29. The cloud-based medical processing system of claim26, wherein the centralized computing device is configured to stored themedical data in a storage array located off-site from the medicalfacility.
 30. The cloud-based medical processing system of claim 26,wherein the centralized computing device is configured to processmedical data received from a plurality of geographically-separatedmedical facilities.